The standard of practice for hand hygiene when hands are visibly soiled is:

• A. Use hand sanitizer
• B. Wipe with a cloth
• C. Wash with soap and water for at least 20 seconds
• D. Do nothing

Answer: (C)

When hands are visibly soiled, washing with soap and water is required to physically remove dirt and microbes. The action of soap and friction under running water helps lift and rinse away grime that sanitizers can’t remove, and the hand-wash duration of at least 20 seconds ensures all surfaces are cleaned—palms, backs of hands, between fingers, under nails, and wrists.

Hand sanitizer isn’t reliable when hands are dirty because the soil can block the sanitizer’s effectiveness and the goal here is removal, not just inactivation. Wiping with a cloth or doing nothing won’t adequately clean or reduce microbes.